The treatment of this form consists first of all in avoiding all substances that are likely to set up or continue the irritable condition of the digestive organs. All alcoholic liquors and highly-seasoned dishes should be avoided, and the general directions detailed on p. 228 as to diet and bowel regulation followed. Let the tippler not delude himself into the belief that just because of his troublesome stomach he needs an occasional nip to keep him up; and let others take ordinary precautions not to take what manifestly disagrees with them. The powder of ipecacuanha is a favourite remedy for such cases in i-grain doses. The cases of chronic irritation—chronic catarrhal conditions —are, however, extremely difficult to treat, and a great many remedies have been tried. A valuable remedy is bismuth. Trousseau, the French physician, advises it in large doses along with precipitated chalk, at least 10 grains of each being taken together before each meal. Failing this, acids may be tried—dilute hydro chloric acid taken in 10-drop doses in water at the end of each meal. Effervescing draughts are also useful, and much benefit has often been derived from such an effervescing draught as Eno's Fruit Salt affords, taken early every morning.
Acid Indigestion is marked by an exces sive secretion of very acid juice. Severe heart burn is common in this form of the complaint, and every now and again a small quantity of the acid material comes up with eructation, seeming to burn all the way up, till all down the gullet feels raw and fiery, and even the teeth are set on edge. This may go on for hours, and be accompanied by a sense of fulness as if the food were unable to escape from the stomach. The acidity is often accompanied by flatulence.
Treatment.—Again it must be insisted on that the person regulates his food with care. The directions on p. 228 as to diet and bowels are particularly suitable to such cases. Now it is certain that often nothing relieves this condition like an antacid (a substance opposed to an acid) such as soda or magnesia, of which half a tea-spoonful may be taken in water. A
tea-spoonful of seidlitz salt dissolved alone in water is useful, and helps also to relieve the bowels. The subnitrate of bismuth, 10 to 15 grains, a quantity that can easily be picked up on a sixpence, is also advised. It is, however, frequently the case that acidity is best treated by other than alkaline remedies, apparently because medicines like soda, &c., stimulate, by their opposition, an increased secretion of acid. Thus acid indigestion yields most readily in many cases to acid treatment, but the acid (10 drops of dilute hydrochloric acid in water) must be given a short time before each meal. When given at this time it checks the excessive secre tion of acid and prevents the development of acid by fermentive changes in the stomach.
Flatulent Indigestion is characterized by the formation of gases in great quantity in the stomach and bowels. The gas is supposed to be produced by decomposition of the food. The gases may have a very bad odour. Their presence is indicated by fulness, distension, and pain, and their movements through the bowels are attended by gurgling noises. Flatu lence is often accompanied by acidity.
Treatment.—In very many cases confirmed flatulent indigestion is due to nothing else than bad regulation of diet, to too long intervals between meals, and to the too frequent use of tea. Let these errors be first of all corrected.
It is in cases of indigestion in which belching up of quantities of gas is a prominent symp tom that milk may prove to be an unsuitable food. Small solid meals at intervals of not less than 4 hours may prove more suitable. But solids which readily ferment must be avoided, such as potatoes, starchy foods like rice, tapioca, &c., and pastries and sweets. Tea should be much restricted in amount, and freshly pre pared and weak, with cream, but very little sugar.
Liquids should be taken apart from meals, preferably an hour before a meal, and gaseous waters should be avoided. Fat and all greasy dishes are objectionable, fresh butter, however, being allowed.
Such a diet would consist of—